In a speech defending Obamacare, the president points to Northampton County woman as an example of its success

— By the time the federal Affordable Care Act passed in 2010, Debra Lea Oren's joints had deteriorated so much she was in a wheelchair, working through a treatment plan that would require replacing both of her knees.

Oren, of Palmer Township, had been suffering from osteoarthritis so severe she was in constant pain. When she was able to stand, she couldn't straighten her legs.

An initial plan for surgery was delayed and then her husband, Michael, lost his job, and with it, their health insurance.

After Obamacare's insurance exchanges opened, Oren was able to purchase a health care plan through Pennsylvania's federally run marketplace. She had surgery, replacing both knees at the same time, and got long-needed blood tests that were critical to managing her thyroid condition.

"My life has changed so much," the 60-year-old said Tuesday in an interview.

So she decided to write the president to thank him, and to let him know how much the health care law meant to her. She didn't expect to hear back.

FACEBOOK PUBLIC PHOTO, CONTRIBUTED PHOTO

FACEBOOK PUBLIC PHOTO, CONTRIBUTED PHOTO

On Tuesday, President Barack Obama relayed the story she wrote to him during a speech before the Catholic Health Association. His remarks offered his appreciation to those who had supported his signature policy initiative and worked on its passage.

He also sought to highlight the law's positive effects as the Supreme Court prepares to rule on a case that jeopardizes the insurance subsidies it provides in Pennsylvania and dozens of other states.

The uninsured rate in Pennsylvania last year dropped to 10.3 percent, down from 11 percent in 2013, and nearly 350,000 residents have received subsidies to purchase insurance, according to White House figures.

Obama said the law has become "part of the fabric of how we care for one another," adding that unraveling it five years after it was approved would roll back significant progress and access to care for millions of Americans.

For Oren, getting coverage meant surgery that enabled her to take steps with a walker days later.

"I bless you every night," she wrote to Obama in February. "I'm able to walk the dogs again. I walk with my husband [Michael] and hold hands. It's like a whole new world for me. You are the one responsible for this wonderful gift."

Obama recited that line from her letter during his speech, repeating the phrase on walking and holding hands. He described her joy at being able to do that seemingly simple activity as one of the law's outcomes that — unlike statistics on lives saved or the number of newly insured families — are more difficult to tally.

"Every day, miracles happen in your hospitals," Obama told the health care providers in the audience. "Remaking Debra's world didn't require a miracle. It just required that Debra have access to something that she and every other American has a right to expect, which is health care coverage."

White House officials called Oren on Monday to ask her permission for the president to mention her in Tuesday's speech.

They also invited her to watch the speech in person, but she declined. She needed to help get her grandson to school.

A year after her surgery, she can do such tasks — cooking, cleaning, running errands or driving her grandson — without the pain she had for so long. Sometimes her activity level still surprises her husband, who occasionally gets confused when the car is missing.

"He'll say to me, 'I just can't get over seeing you walking again. It's so good to see you walking,'" Oren said.

She hopes the Supreme Court ruling, expected this month, will keep the law intact. She doesn't rely on the subsidies now that her coverage is through the state's expanded Medicaid program instead of the exchange, but she said the premium assistance is vital to those struggling to make ends meet.

In her letter, Oren reminded Obama of that need, telling him to keep fighting against those who want to dismantle the law.

"Please don't let the Republicans bully you," she wrote. "We people at the bottom of the ladder love you for the hand up."